Written Answers Nos. 820-835
820. Deputy Fergus O'Dowd asked the Minister for Health the powers the public authorities had in dealing with private nursing homes which were failing to comply with public health guidelines during phase 1 of the pandemic; and if he will make a statement on the matter. [24774/23]
View answerThe COVID-19 pandemic has presented one of the greatest and most wide-ranging public health challenges internationally in recent history. The pandemic was a hugely difficult time in particular for all residents, relatives and staff of nursing homes.
The State’s responsibility to respond to the public health emergency led to the establishment of a structured nursing home support system, in line with National Public Health Emergency Team (NPHET) recommendations, to provide enhanced supports to public and private nursing homes. In order to support continuity of service and infection prevention management, a comprehensive package of direct and indirect supports was established in early 2020 and remained in place throughout.
Supports
The supports provided over the course of the pandemic have included:
• Enhanced HSE engagement;
• Temporary HSE governance arrangements for some private and voluntary homes;
• Multidisciplinary clinical supports at Community Healthcare Organisation (CHO) level through 23 COVID-19 Response Teams.
• Substantial support and advice through the Departments of Public Health and Outbreak Control Teams;
• The HSE through the COVID-19 Contact Management Programme and the Public Health Departments prioritised the investigation and management of outbreaks in nursing homes;
• Access to supply lines for personal protective equipment (PPE), medical oxygen etc. including access, free of charge, to PPE on both a precautionary and an outbreak basis;
• HSE training and development resources, including the opening up of the HSE’s online training portal and learning resources (HSELanD) to private and voluntary providers.
• Infection Prevention and Control (IPC) support and advice, including a package of IPC guidance produced and published in March 2020, in addition to the pre-existing HSE and HIQA guidance.
• Access to staff from HSE community and acute hospitals: from an early stage the HSE mobilised considerable staff resources, making them available to nursing homes where possible.
• A substantial suite of guidance (visiting, IPC) was developed to support the nursing home sector and updated regularly as new evidence emerged and the epidemiological profile changes was developed.
• The HSE ran a programme of serial testing of all staff in nursing homes. The programme commenced on 24th June 2020 and operated in full until approximately April 2021, after which nursing homes were permitted to exit the programme if they met nationally agreed exclusion criteria.
• Free temporary accommodation to nursing home staff to support measures to block the chain of transmission. This scheme ran up until May 2022.
• As part of package of support measures for nursing homes, the Minister established a COVID-19 Temporary Assistance Payment Scheme (“TAPS”) for private and voluntary nursing homes, providing for a publicly funded contribution to their preparedness, resilience and the management of COVID-19 outbreaks. The Scheme opened for applications on 17th April 2020 and delivered in excess of €149m in funding to the private and voluntary nursing home sector over the course of the pandemic. This payment was extended to the end of April 2023 and subsequently closed as the frequency and severity of outbreaks has greatly reduced.
It is important to note that nursing home providers are ultimately responsible and accountable for the quality of care and safety of their residents. In addition to the comprehensive package of supports to assist and support providers in this regard, HIQA continued to regulate these registered providers throughout the pandemic. In line with international best practice, on-site inspections were temporarily suspended to prevent the spread of infection amongst nursing homes; however, HIQA remained in regular contact with the providers and managers of centres to monitor their ability to protect residents in the event of an outbreak of COVID-19.
The Chief Inspector undertook a number of initiatives at this time in relation to nursing homes in order to ensure the safety and welfare of residents and to support service providers in keeping people safe. They include the following approaches:
• A quality assurance process was set up, whereby all nursing homes were phoned on a fortnightly basis by an inspector of social services. These calls were to assess the welfare of the residents, how nursing homes were coping, any concerns they had and any deficiencies identified in their ability to sustain a safe, high-quality service.
• New registration applications were prioritised to facilitate the swift opening of new residential placements.
• An ‘Infection Prevention and Control Hub’ support service was set up by the Chief Inspector. The Hub, staffed by inspectors with experience in infection prevention and control, acted as a source of immediate advice and support for centres that had queries on COVID-19 outbreak prevention and management.
• Eight regulatory information notices were issued to registered providers between 20 March and 26 June 2020. These were aimed at enhancing the flow of notifications that providers are required to make to the Chief Inspector. This enabled the timely return of data on the number of residents and staff with suspected or confirmed cases of COVID-19, and the number of deaths in each centre.
• There was regular liaison between the Chief Inspector and the Department of Health and the HSE regarding ongoing issues in services and the escalation of risk.
• The Chief Inspector carried out a programme of inspections to assess the preparedness and contingency planning for COVID-19 outbreaks in those nursing homes that had not yet had a suspected or confirmed case of the disease.
• The Chief Inspector also carried out a separate targeted programme of risk-based inspections focusing on those nursing homes that were most impacted by COVID-19.
Further information regarding HIQA’s input and involvement process in nursing homes during phase 1 of the pandemic can be found in the following reports:
The impact of COVID-19 on nursing homes in Ireland, published July 2020.
An Overview Report on the Monitoring and Regulation of Older Persons Services in 2021 and 2021, published December 2022.
821. Deputy Fergus O'Dowd asked the Minister for Health if any warning letters were issued by the HSE or HIQA outlining concern on failures to comply with regulations issued to nursing homes in April 2020; if so, how many; and if he will make a statement on the matter. [24775/23]
View answerThe Chief Inspector of Social Care and the Health Information Quality Authority (HIQA) is the national independent regulator of Public Community Nursing Units and Private Nursing Homes. All these homes are subject to registration and inspection by HIQA, which is underpinned by a comprehensive quality framework comprising Registration Regulations, Care and Welfare Regulations and National Quality Standards. In 2022 HIQA published an overview report on the monitoring and regulation of older persons services in 2020 and 2021. This report is available www.hiqa.ie. This provides an overview of the findings of the regulation of designated centres for older people throughout 2020 and 2021 by the Chief Inspector of Social Services. HIQA has advised my Department that between 1 April 2020 and 30 April 2020, HIQA did not issue any warning letters to nursing homes. At that time, the country, including nursing homes, were in the very early stages of managing the impact of COVID-19. The regulatory focus during that unprecedented time was in relation to the management on COVID-19.
822. Deputy Duncan Smith asked the Minister for Health how many people between 20 and 65 years of age are living in nursing homes in Ireland; and if he will make a statement on the matter. [24776/23]
View answer823. Deputy Duncan Smith asked the Minister for Health how many people between 20 and 65 years of age living in nursing homes in Ireland are in the fair deal scheme; and if he will make a statement on the matter. [24777/23]
View answer824. Deputy Duncan Smith asked the Minister for Health how many people between 20 and 65 years of age living in nursing homes in Ireland are in public nursing homes; and if he will make a statement on the matter. [24778/23]
View answer825. Deputy Duncan Smith asked the Minister for Health how many people between 20 and 65 years of age living in nursing homes in Ireland are in private homes; and if he will make a statement on the matter. [24779/23]
View answerI propose to take Questions Nos. 822, 823, 824 and 825 together.
As these are operational matters, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
826. Deputy Michael Healy-Rae asked the Minister for Health if he will address the case of a person (details supplied); and if he will make a statement on the matter. [24781/23]
View answerAs this is an administrative matter for the Health Service Executive, the HSE has been asked to respond directly to the Deputy.
827. Deputy Emer Higgins asked the Minister for Health the financial supports that are available to patients who are required to carry Epinephrine Injections (EpiPens) on their person in case they experience severe anaphylaxis; and if he will make a statement on the matter. [24784/23]
View answerThis Government has put a significant focus on improving access to and the affordability of healthcare services, advancing substantial policy, legislation and investment to deliver expanded eligibility.
In accordance with the provisions of the Health Act 1970 (as amended), eligibility for a medical card under the General medical Services (GMS) Scheme is determined by the HSE. In certain circumstances, the HSE may exercise discretion and grant a medical card, even though an applicant exceeds the income guidelines, where he or she faces difficult financial circumstances, such as extra costs arising from illness.
In circumstances where an applicant is still over the income limit for a medical card, they are then assessed for a GP visit card, which entitles the applicant to GP visits without charge.
On 1 November 2020, the statutory prescription charges payable under the GMS Scheme were reduced to €1 per item for those over 70 (with a maximum cap of €10) and to €1.50 per item for those under 70 (with a maximum cap of €15). The weekly gross income thresholds for eligibility to a medical card for those aged 70 and over were also increased in November 2020.
The Drug Payment Scheme (DPS) provides for the refund of the amount by which expenditure on approved prescribed medicines or medical and surgical appliances exceeds a named threshold in any calendar month. The DPS is not means tested and is available to anyone ordinarily resident in Ireland.
The DPS threshold was reduced twice in 2022:
• From €114 to €100 per month on 1 January 2022.
• From €100 to €80 per month on 1 March 2022.
Therefore, currently, under the DPS, no individual pays more than €80 a month towards the cost of approved prescribed medicines. The DPS significantly reduces the cost burden for people with ongoing expenditure on medicines.
In 2022, a range of other measures were delivered which also reduced medical costs. These include the abolition of public inpatient charges for children and the introduction of free contraception for women aged 17-25.
The significant investment in Budget 2023 will facilitate better access to affordable, high-quality healthcare for people at a time when the cost-of-living crisis is impacting on everyone. In 2023 this will mean:
• an expansion of GP care without charges to people earning no more than the median household income,
• all public in-patient hospital charges abolished since 17 April 2023,
• an extension of free contraception to 26-year-old women since 1 Jan 2023, and further extension to 27-30 years old women from 1 September 2023.
These measures continue to create a health and social care service that offers affordable access to quality healthcare.
Individuals may also be entitled to claim tax relief on the cost of their medical expenses, including medicines prescribed by a doctor, dentist, or consultant. Relief is at the standard tax rate of 20%.
828. Deputy Holly Cairns asked the Minister for Health to provide an update on the announced funding for participants in a psychology training programme (details supplied); and if he will make a statement on the matter. [24796/23]
View answerAs you will be aware, €750,000 has been provided in Budget 2023 to support counselling psychology training places. This funding demonstrates the Government’s commitment to strengthen access to psychology training.
I am focussed on supporting counselling psychology students in an equitable way and that delivers value for money. The structure of this funding is still being finalised by officials in the Department. The approach will be based on best practice and knowledge gained from other health and social care funded training models.
Further detailed discussions are required between the Department and HSE to progress this. I hope to be in a position to announce the details shortly for academic year 2023-2024.
829. Deputy Holly Cairns asked the Minister for Health the steps he is taking to ensure that an out-of-hours GP service is open after 9 p.m. (details supplied); and if he will make a statement on the matter. [24797/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
830. Deputy Mick Barry asked the Minister for Health the amount in the capital budget as set out in table 13 of the Stability Programme Update 2023 that is designated for infrastructure to support Community Healthcare Networks; and if he will make a statement on the matter. [24802/23]
View answerTable 13 of The Stability Programme Update 2023 (SPU) sets out the Fiscal projections for 2023 - 2026 at National level. It does not set out allocations of capital funding within sectors. Planned Departmental Capital Allocations are set out in the National Development Plan.
A 5-year allocation to 2025 of €5.657bn has been allocated to the Department of Health as part of the review of the National Development Plan (NDP). This allocation provides an 11% increase in funding year on year to 2025, which will support the strategic direction of health capital investment in the period.
A central objective of the Programme for Government is to deliver increased levels of integrated health care with service delivery reoriented towards general practice, primary care and community-based services to enable a “home first” approach.
Infrastructure to support Community Healthcare Networks is funded through a number of areas in the annual capital programme, including Enhanced Community Care, Community Services, and Infrastructural Risk. Funding for these areas of the capital programme are included in the overall building and infrastructure capital allocation of €1.027 billion for 2023.
831. Deputy Mick Barry asked the Minister for Health the estimated cost of providing 20 additional dedicated children's beds for psychiatric care to stop the practice of using beds in adult psychiatric services; and if he will make a statement on the matter. [24803/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
832. Deputy Mick Barry asked the Minister for Health the estimated cost of implementing the Connecting for Life suicide prevention programme in a full year. [24804/23]
View answerIreland’s national suicide and self-harm reduction strategy, Connecting for Life, was launched in June 2015. In December 2019 the Department of Health supported an extension of Connecting for Life for a further five years to 2024, with official approval by Cabinet granted in November 2020. This followed the completion of an Independent Interim Strategy Review of Connecting for Life 2015-2020, which concluded that the seven strategic goals of Connecting for Life remained relevant beyond 2020.
Connecting for Life is made up of 7 goals, 69 actions, and is cross-governmental in scope, with a whole of population public health focus, reflective of the complex challenge that suicide and self-harm prevention presents.
The HSE National Office for Suicide Prevention (NOSP) is responsible for the implementation of Connecting for Life. NOSP sits within the Mental Health Community Strategy and Planning function of the HSE and works closely with HSE Mental Health Community Operations and others. Its role is to support, inform and monitor, in addition to coordinating, the implementation of Connecting for Life.
The NOSP expenditure for 2022 was €14m, this is implemented under the below headings in relation to Connecting for Life. Further information on previous years expenditure can be found in the NOSP annual reports at www.hse.ie/eng/services/list/4/mental-health-services/nosp/about/annualreports/. The 2023 budget for NOSP is €14.15m.
HSE NOSP expenditure in 2022
|
2021 |
2022 |
|
|
Grants to agencies(breakdown next page) |
7,384,509 |
7,065,772 |
|
Communications projects |
1,257,615 |
1,157,226 |
|
Research |
501,975 |
505,258 |
|
Non-grant expenditure(Office expenses, salaries, overheads, etc) |
1,108,439 |
1,333,995 |
|
Training programmes(Non-clinical training, clinical training and National DBT Project) |
1,183,663 |
1,582,627 |
|
Regional liaison and suicide prevention servicesCapacity building |
1,307,240 |
1,307,240 |
|
Resource Officers for Suicide PreventionLocal Connecting for Life Implementation PlansGrants to agencies via CHOs |
1,326,226 |
1,050,286 |
|
Total |
14,069,666 |
14,002,404 |
833. Deputy Mick Barry asked the Minister for Health the estimated cost of implementing the Sharing the Vision strategy in a full year. [24805/23]
View answerSharing the Vision - A Mental Health Policy for Everyone, Ireland’s national mental health policy, was published in June 2020. Sharing the Vision aims to enhance the provision of mental health services and supports across a broad continuum, from mental health promotion, prevention and early intervention to acute and specialist mental health service delivery, during the period 2020-2030.
Sharing the Vision Implementation Plan 2022 – 2024 was collaboratively developed by the HSE and the Department of Health, overseen by the National Implementation and Monitoring Committee (NIMC). The NIMC is tasked with the implementation monitoring of the policy. The Plan sets out individual programme pathways of implementation for each of the 100 policy recommendations for the next three years.
Sharing the Vision, has a ten-year implementation roadmap, overseen by the National Implementation and Monitoring Committee (NIMC). There is no single set implementation budget for the work required to implement the full programme of recommendations or workstreams as responsibility for implementation is spread across different care areas, including primary care, mental health planning, mental health services, HSE social inclusion, among others. There is a core operational budget in HSE Mental Health Operations of €646,000 for Sharing the Vision programme implementation which covers service improvement lead salary costs and other expenses that arise, for example the Sharing the Vision learning event in March 2023.
Any additional funding required for developments under this strategy will be based on the NIMC’s work plan, which will identify priority developments relevant to each care area for each year. This funding will then be sought as part of the estimates process and in close conjunction with the development of the HSE National Service Plan each year.
834. Deputy Denis Naughten asked the Minister for Health his plans to establish a clinical lead for haemochromatosis; and if he will make a statement on the matter. [24809/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
835. Deputy Denis Naughten asked the Minister for Health if he will list the acute hospitals and primary care centres which perform venesection for patients with haemochromatosis; and if he will make a statement on the matter. [24810/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
